Dear All,
What I would suggest to the countries endemic for PPR, is to focus on an organized vaccination strategy rather than going for sero-surveillance / clinical surveillance for at least 3 years. The vaccination strategy can again be economized (Ist year- carpet vaccination, followed by two annual vaccinations of unvaccinated and young ones). This can avoid expenditures on diagnostics and its use. Subsequently, these diagnostics can be applied to asses the status of disease intensity or antibody prevalence. Of-course during eradication stage there is no short-cut except to follow a standard/ OIE pathway of disease eradication, which requires organised serological/clinical surveillance.
Kind regards,
R.P.Singh
Dr. R.P.Singh,
Principal Scientist, Division of Biological Products,
Indian Veterinary Research Institute, Izatnagar,
Bareilly-243 122 (Uttar Pradesh),
India
Alternate email: [log in to unmask]
Mobile:+91-9412360917
----- Original Message -----
From: michael baron
Sent: 02/12/14 02:06 PM
To: [log in to unmask]
Subject: Re: From Dr Eunice Ndungu, Kenya on strengthening the coordination, sustainability and standardization of laboratories
Dear Colleagues,
if I may make a couple of comments in reply to these suggestions
1) The OIE already has its twinning program aimed at exactly this process. It is generally successful (although limited by the number of people in the Reference Labs to do the training etc.). However, the technology involved in most of the diagnostic assays available are not very high tech. Great things are still being done in many so-called "undeveloped" laboratories with robust and reliable ELISAs. Gel-based PCR is fairly widespread, and again reliable. What is often lacking are systems to bring samples to the central laboratories. If the field workers do not collect samples and send them in, it is ruinously expensive for the central laboratories to have to send out expeditions to see if they can find some. Transport links are a big problem, and finding ways to get vaccine to the field, and samples back from the suspected outbreak, are a bigger problem than the technology available in the laboratory, I would suggest.
2) There has already been comment here on the benefits of having a small number of suppliers of kits. Such kits can have extensive testing and quality control, and trouble shooting can be shared among a network of laboratories, as with the network run by IAEA/FAO during the rinderpest campaigns. Quality would be a real problem with this suggestion. As already raised in point 3, you are saying we do not yet have high quality even in the use of the kits, in many of the labs where PPR is endemic. Expecting the same labs to grow hybridomas and purify protein reagents to manufacture kits is probably not reasonable. The kits cost to produce and to buy, but that has to be set off against the fact that the purchaser avoids all the development and testing costs. I can understand why Dr Singh and colleagues developed their own diagnostic tests in India, but that was only cost effective because they were producing kits for the whole of India, and they were going to need a lot of kits.
I would also suggest that the cost of 1 test is small compared to the cost of getting the sample back from the field. In the case of the penside test we have produced (declaration of interest required, apologies; I am not trying to advertise, just using an example I am familiar with), it is not cheap, and would be silly to use, as a couple of people have suggested to me, as a rapid laboratory test. The cost of a penside test, however, is much less than the cost of ferrying samples to the lab and carrying out a test there.
We can get hung up about the cost of reagents and kits, because we have to sign the purchase orders. As part of the overall cost of the process, they are not so big, I would suggest.
3) & 4) 100% in support of this. Improving quality systems for the labs and designing effective strategies for conducting the surveillance are really important. The latter picks up on other comments about the need to know the epidemiology and socio-ecology of the disease and its hosts, without which we cannot get the surveillance right.
On the participation proficiency testing, a problem can come here with the need to circulate samples for testing (ring trials). In many cases, it is impossible for labs to import samples that may contain virus, so they can't do the ring trials. There is a need for governments to accept the need for their CVLs to take part in ring trials for precisely this QA purpose. This is a very high level problem, and may need diplomatic nudging from OIE and or FAO.
best regards,
Michael
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Michael D. Baron Ph.D. ([log in to unmask])
Group Leader, Paramyxo&Bunyavirus
The Pirbright Institute,
Ash Road, Pirbright,
Surrey GU24 0NF U.K.
Tel 01483 231024 (office)
Tel 01483 231145 (lab)
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*From:* Establishment of a PPR Global Research and Expertise Network (PPR-GREN) [[log in to unmask]] on behalf of Paul Rossiter [[log in to unmask]]
*Sent:* 12 February 2014 06:41
*To:* [log in to unmask]
*Subject:* From Dr Eunice Ndungu, Kenya on strengthening the coordination, sustainability and standardization of laboratories
Dear Colleagues,
My name is Eunice Ndung’u and I am currently working at Veterinary ResearchCentre, Muguga,Kenya Agricultural Research Institute. I wish to thank the GF TADs PPR Working Group for registering me to the PPR-GREN E-conference. Valuable inputs to ongoing PPR E-conference have been made by various contributors. In addition to inputs already made, the proposed strategy for PPR eradication process should also take into consideration the following:
*1) Coordinated technology transfer to all network laboratories:-*Collaborations between well developed international laboratories and other laboratories should be strengthened or established where they are nonexistent. This will facilitate technology transfer especially specific diagnostic tools that are critical to PPR surveillance.
*2) High cost of reagents/kits/ diagnostic tools:* The cost of acquisition of reagents and test kits would be minimised or eliminated altogether if the technology for preparating various diagnostic kits is transferred to selected laboratories located in regions where PPR is endemic (many African countries from Northern Africa to Tanzania, in the Middle East, in Central and Southern Asia and in parts of China).
*3)There isneed to ensurequalitycontrol /assurancein alllaboratories*dealing withresearchanddiagnosis:- Implementation of international standards/quality management systems andexternal qualityassuranceprogramme thatincludesparticipation proficiency testing programme.This will assure the quality and reliability of results generated by laboratories.
4) Eradication strategyto includeef *fective coordination systems*thatensurethatPPRcontroland subsequent eradication activitiesutilizestandardized and harmonised surveillance guidelines.
Eunice Karungari Ndung’u
Senior Research Officer,
Veterinary Research Centre, Muguga,
Kenya Agricultural Research Institute.
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